They will never forget how you made them feel.

Donna Sollenberger, EVP & CEO, UTMB Health SystemI remember one year growing up in Springfield, Illinois, my uncle developed a chronic illness which, I believed and was wholeheartedly convinced, required a specialist. I attempted to persuade him to see a physician who specialized in his chronic condition. It would be easy, I told him, because I could arrange the appointment. However, my uncle declined. He wanted to stay with his current physician.

Not one to let things lie, I probed more closely. Why would he prefer to stay with his current physician and decline seeing the doctor that specialized in the chronic condition? His response interested me. He said that his current physician delivered a great quality of care for him. Why would he change now? So, I continued my probe.

How did my uncle know that his physician delivered great quality of care? His multi-faceted answer was even more insightful. It seems my uncle assessed the quality of care he received from his doctor in a way that most non-clinical people do, even today—they base it on the quality of their experience. To my uncle, a quality patient experience was about the following:

  • My doctor and his staff know me, so I can always get through when I contact them and get my questions answered or my needs met.
  • They always call me back within the day.
  • They are close to my home, so it is easy for me to drive there.
  • If I am sick, they always work me in that day.
  • Parking is easy and free.
  • My doctor’s office is new and pretty.
  • My doctor always has time to listen to me.

For a health care professional, it might seem odd that there is nothing in the above assessment regarding the training and experience of the physician, the access to other physicians for consultation, the way in which the chronic condition is managed so that it is under control—even in remission. There is nothing in his preferences about access to the best equipment, use of evidence-based guidelines in the patient’s treatment, or about the outcomes of other patients. My uncle’s entire assessment of the quality of his care was based solely on the experience he had as a patient visiting his physician. And yet, my uncle believed the quality of his care was outstanding.

Over the years, I have come to learn that the value of the patient experience cannot be underestimated. As a provider, we can do everything well in terms of the patient care delivered and the care interventions we make, but if the patient does not feel that they were treated with compassion and respect, or if they do not feel that we were responsive to their needs, or if they have trouble getting access to an appointment time that was convenient or timely for them, or if they felt they were not being listened to because the physician and/or staff never made eye contact with them or the conversation was rushed, the patient will not perceive that she or he is getting the quality of care s/he deserves. In short, the patient experience is crucial to the patient feeling as if they are receiving quality care.

In the past months, we have been focused on Best Care, which means we are upholding our unwavering commitment to deliver the right care, at the right time, in the right way, for the right person – and achieve the best possible results – for every patient, every time. One of the components of Best Care is patient-centered care, which means “providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions” (Institute of Medicine, 2001).

Every employee at UTMB in some way impacts how well we perform in the areas mentioned above—whether that contribution is direct or indirect in terms of the patient. It is true, sometimes in a large organization like UTMB, an individual who doesn’t directly “touch” a patient might not immediately realize how what one does truly helps or impacts the patient. If you feel that way, just think of a line of people passing buckets of water from one to the other from a source of water to be poured into a large water tank. An individual in the beginning or middle of the line may not be able to see the end result (i.e., the water being thrown into and filling the water tank), but the contribution of the individual is indispensable to the final outcome.*

Every interaction a patient has with our system influences their experience!

At UTMB, we are dedicated to providing an exceptional experience with excellent outcomes to all patients, no matter who they are, what their background is, what age they are, what their gender, race or ethnicity is, or how much insurance coverage or ability to pay they may have—this is equity of care, another focus of Best Care.

So, what can each person at UTMB can do to contribute to the patient experience? The following are just a few easy things we can all do, but there are ultimately countless actions we can take, and I encourage you to think about how you make a difference in your own important role:

  • Always warmly greet and assist patients and visitors—and one another.
  • Treat all patients and visitors with respect.
  • Be aware when someone looks lost or confused and offer to help them to their destination or point them to someone who can assist.
  • Assure equipment, supplies and medications are available for all patients at all times.
  • Conduct timely equipment inspections.
  • Provide language interpreters and interpreters for the hearing impaired; you can receive certification to assist in this endeavor through language services.
  • Attend training to increase ability to care for diverse groups of patients.
  • Work in teams and as a team.
  • If your personal finances permit, contribute to programs like the UTMB Good Neighbor program.

There is a quote attributed to speechmaker Carl W. Buehner (and a few others) that says, “They may forget what you said—but they will never forget how you made them feel.” This can certainly be applied to the patient experience—whether you deliver patient care, respond to the patient’s concerns, ensure supplies and lab samples are delivered, help patients access our system, help them find the resources they need, or you create a warm, welcoming environment, you all contribute to the feeling of being well cared for at UTMB Health. I appreciate everything you do to create an excellent patient experience and to contribute to Best Care.

*Concept adapted from Grant Bright, Former Project Lead, IBM

**In addition to patient-centeredness and equity of care, the remaining areas of focus for Best Care include effectiveness of care, efficiency, patient safety and mortality, as measured by the Vizient Quality & Accountability Study.

Best Care Update

Donna Sollenberger, EVP & CEO, UTMB Health SystemAs you all know, we experienced a fire in John Sealy Hospital last week. Although some of our teams are now working in temporary locations until the hospital can be restored, we have resumed normal operations. So this week, I am again looking ahead to Best Care and what we need to do to assure that we will rank in the highest quartile of performance as measured by the Vizient Quality & Accountability Study.

We have done much work since June when we began working in earnest to improve outcomes of care for our patients. As a result of that work, we are starting to see improvements in our performance. We all remember that when we began the Best Care initiative, we ranked in the top 20 out of 102 academic medical centers in both equity of patient care (this means that our patients get the same care, regardless of their race, ethnicity, sexual orientation, economic status, etc.) and in patient-centered care.

Moving forward, we needed to remain a top performer in both of these categories, and to date, we have accomplished this. For example, our goal in patient-centeredness for the first quarter of the fiscal year was to have 76.4 percent of our patients rate us on the patient satisfaction survey as a nine or ten (on a scale of one to ten) for their overall experience of care. And there’s good news—for the first quarter of FY17, 81.6 percent of our patients rated us at the top of the scale! This is excellent work, and we need to keep it up!

Our work to increase patient safety has also been exceptional. For this measure, we use a rating called the Patient Safety for Selected Procedures Composite Score (a measure developed by the Agency for Healthcare Research and Quality), otherwise known simply as PSI-90. Patient Safety Indicators (PSIs) reflect the quality of care inside hospitals, but focus on potentially avoidable complications and adverse events following surgeries, procedures and childbirth. These types of events include, but are not limited to, the rate of pressure ulcers, falls in the hospital resulting in hip fracture, the rate of hemorrhage or hematoma after surgery, and the rate of postoperative sepsis (a severe bloodstream infection resulting in decreased organ function). We are doing exceptionally well with this measure. Our target score for the first quarter was 0.91 and we scored 0.65 (lower numbers are better, in this case). Our target for next quarter is 0.80, so we need to keep up this excellent work and do all we can to do even better!

For preventable readmissions within 30 days of discharge, we exceeded our first quarter target of 13.6 percent—our performance was 12.5 percent (again, lower numbers are better). This means that we did a good job of managing our patients once they left the hospital, we followed up with them to make sure they were following their care plan, and/or we managed their health in our clinics so they did not come back to the hospital within the 30-day time frame. While this is excellent work, we increase the challenge to meet our targets each quarter so that we have to continually improve. For the next quarter, our goal for the 30-day all-cause readmission rate is set at 12.58 percent or less, so we have to keep improving!

We also met our goal to reduce our mortality rate, which is described as a ratio that compares how many patients passed away, in total, compared to how many were expected to pass away while in the hospital based on how sick they were. A significant part of the effort to improve our rate has been rooted in clinical documentation improvement, because the more specific the documentation is, the more accurately the patient’s severity of illness is reflected. Additionally, if we do not document the care we deliver to our patients well enough, our performance appears worse than it actually is—even if the care was excellent and the patient had a good outcome. To help support our providers in this endeavor, we have been working to optimize our electronic medical record (Epic), and we are also offering documentation training to physicians on our inpatient units—for example, providers should not use symbols when documenting, and it is important to use special and specific wording when describing the patient’s condition.

For the mortality score, a score of less than 1 means that more patients survived than were predicted to. A score of more than 1 means that more patients passed away than were predicted to. So, a lower score is better. This quarter, our mortality observed/expected rate was 0.91, where our target was 0.99. Since lower numbers are better, this means we met our goal. For the next quarter, however, our target is 0.90, so we have some more work ahead of us.

The last major measure we are tracking is length of stay (LOS). This falls under the Vizient Quality & Accountability Study’s category of Efficiency, which measures how well we are using our resources compared to how ill the patient is. This measure is case mix index adjusted, which essentially means that it takes into consideration the diversity, clinical complexity and resources needed to care for our total hospital patient population. Our goal for this first quarter’s LOS at the Galveston campus was 2.85 days. At 2.96 days, we missed our goal. We have a significant amount of work to do, because for next quarter, our goal will be 2.81 days.

I know many of you have asked me how we are doing when it comes to achieving Best Care. If I were to summarize, I’d say we are on the right track and moving in the right direction. But to meet the goals we have for the end of this fiscal year, we have stay focused and maintain our absolute resolve to meet our Best Care goals.

I want to thank each of you for our improvements made since June. I know this requires a lot of work, but if we can make these improvements stick, ultimately, our work will become easier. And even more importantly, our patients will receive the Best Care.


*Lower numbers are better

Everyday Heroes

Donna Sollenberger, EVP & CEO, UTMB Health SystemMost of you already know that I was not here for Hurricane Ike. I arrived to work at UTMB one year and a day afterward. My first day of work at UTMB, I remember standing in the grassy area in front of John Sealy Hospital during the Hurricane Ike Commemoration Ceremony. Dr. Callender was surrounded by a small group of employees who listened to him talk about the progress the organization had made over the past year, and he reflected on the experiences of the first days after the storm. He recalled the extraordinary effort of some of our facilities colleagues who made sure the UTMB sign on John Sealy Towers was lit. Then, the ceremony ended, and the UTMB flag was raised by two of our students. I stood at the back of the small crowd, listening and watching the emotions of the people there. It was obvious that the memories of this experience were still quite vivid and emotions were still raw. There was still much healing to be done.

About two years ago, UTMB had the opportunity to host the University of Texas System Board of Regents and members of UT System leadership at a dinner reception. That evening, Dr. Joan Richardson, chair of the Department of Pediatrics, spoke of her love of heroes when she was a girl. She told us that she had always wanted to know a hero, but had not had a chance to know one—that is, until September 2008. As she described the work of hundreds of people who rode out the storm and the many others who came back to work tirelessly to reopen UTMB, she said that she realized she knew hundreds of heroes. They came from every walk of life, and they all had one thing in common—their resolve to reopen UTMB. UTMB stopped for no storm.

I remember the absolute silence that evening as the audience sat mesmerized at the story of the heroes at UTMB. There were few dry eyes in the room when Dr. Richardson finished her story. I remember thinking how lucky I was to work with people who made sure that UTMB, like the mythical phoenix, rose again from Hurricane Ike’s devastation.

Houston Fire Department to the rescue!

Houston Fire Department to the rescue!

This past Wednesday, I experienced what Dr. Richardson described. I was walking toward the Administration Building on the Galveston Campus when I saw a fire truck and two escort cars arrive in the front of John Sealy Hospital. It is not unusual to see an emergency vehicle or two in front of the hospital from time to time, and it generally is not a serious issue. But as I watched two of our police officers run past me and into the east entrance of John Sealy Hospital, I realized something serious was happening. Within minutes, we learned that a fire, yet uncontained, had broken out on the second floor and that smoke was in the stairwells and moving throughout the building. We declared an emergency at UTMB.

Transportation staff in action

UTMB Transportation staff in action, waiting in front of Jennie Sealy Hospital to transfer patients.

Working with local fire departments, a decision was made to evacuate the 110 patients, their visitors and our staff in John Sealy Hospital. Although this was an intense situation, our staff, physicians and managers remained calm and focused on getting everyone out of the building. As the patients were being safely transferred out of the building, we simultaneously needed to decide on where to place the patients. Administrators, doctors and managers worked together under pressure to identify the best places to continue care for our patients in our care facilities. I applaud every one of you who helped moved our patients to new locations, got them settled in, and worked to assure that their needs in these new areas were met. It was a challenging situation, but everyone problem-solved and worked together to get what was needed to help our patients.

A hero is defined as someone who makes a personal sacrifice in order to benefit others or someone who is noted for their courageous action. I now know from my own personal experience what it is like to work with hundreds of heroes. To everyone who made the safe evacuation of 110 patients possible on Wednesday, you are the heroes of UTMB! Thank you for the personal sacrifice and the risks that you took to benefit so many others!

Thank you to the Galveston Firefighters, the Galveston County Health District EMS, the Galveston Police Department, Island Transit, the Houston Fire Department, and Santa Fe Fire & Rescue for coming to UTMB’s aid!

Holiday Traditions

Donna Sollenberger, EVP & CEO, UTMB Health SystemGrowing up in the Midwest, I always wished for snow during the winter holidays. As you know, our family celebrates Christmas, and snow on Christmas Day meant two things. First, I got to play outdoors with all of my cousins, and, if the snow was moist enough, we could make snowmen. Second, after dinner with all of my aunts, uncles and cousins, all of the children would wait patiently (as patiently as we could, that is) until dusk, because it meant that my mom’s cousin would hook up the horses to the sleigh, and we would all be treated to sleigh rides around the snow-covered countryside. It was especially magical if the snow was still falling and fresh on the ground, because the sleigh would glide silently along with only its lights to help show the way. Just writing about those sleigh rides now, I re-experience the warm feelings of Christmas days past.sleigh

Determined to create our own traditions once we were married, my husband and I decided to give each of our children a traditional gift that they could count on each Christmas. Each year, we gave our daughter a bell ornament. Each of our twin sons received nutcrackers. These were small gifts, but they became significant in the lives of our children. I recall one particular Christmas evening, I was tucking one of the twins into bed, and I asked him what his favorite present had been. He had a particularly bountiful Christmas, getting a fishing rod and reel, a Game Boy, and some other smaller toys.

His response surprised me. Without stopping to think, he said, “My favorite present this year was my nutcracker.” This twin is now a grown man with a family of his own, but it warms my heart when I visit him right before the holidays, and among his family’s modest set of decorations, a line of nutcrackers from years past are lined up on the shelves in his living room. For him, they bring warm feelings of family. In a way, they transport him back in time across thousands of miles to many Christmas mornings.

I would like to think that everyone grew up with wonderful winter holiday traditions and memories, but we know that is not the case for everyone. Some families would not have gifts without the generosity of Secret Santas who “adopt” them through not-for-profit organizations. Others might not enjoy a nice holiday meal, were it not for generous donations made to food pantries, or for the volunteers who cook and serve those meals. Still many others struggle with health problems or are experiencing circumstances that make the holidays seem lonely or bring sadness or despair.

I know that many of you have been so generous this year by contributing to the recent UTMB Health Food Drive in support of Ball High School’s “Share Your Holidays Food Drive” (sponsored by ABC13). In fact, I learned that UTMB contributed nearly a ton of food to the Galveston County Food Bank. In combination with donations from all others throughout the area, this will provide 18,641 meals for our neighbors in need this holiday season.

Julian Ramirez, Larry Krcma, Sharon Lacy and Lori Blackwell load a van with food donations

Julian Ramirez, Larry Krcma, Sharon Lacy and Lori Blackwell load a UTMB catering van with food donations.

Many others of you are adopting families this year from organizations like the Salvation Army. And still many others of you will help fill the void of family as you care for our patients who will be hospitalized over the holidays. We deeply appreciate your contributions to the well-being of our patients and the sacrifices you make to assure that our patients will be receiving the very Best Care.

As we head into the holiday season, I hope that we will all be mindful of the needs of others around us. I have always believed that the true meaning of the holidays is found when we make things better for others.

The following are 10 easy ideas to brighten the holidays for someone else:

  1. Visit those who are lonely.
  2. Make a random act of kindness.
  3. Decorate someone’s home who cannot decorate for themselves.
  4. Adopt a family.
  5. Give what you can (you don’t have to spend a lot of money to show you care!).
  6. Give your time, whether simply sharing your company or through volunteering.
  7. Contribute to Toys for Tots or another toy drive.
  8. Help the homeless.
  9. Make a charitable donation.
  10. Pay it forward.

There are many traditions this time of year, but one thing is certain. This is a time of giving and sharing with those around us, and that sharing is not only limited to those that we love and care for. It is also for the person that we have never met and will never see.

The Simple Gift of Presence

Donna Sollenberger, EVP & CEO, UTMB Health SystemHave you ever gone somewhere with a friend or family member, and the other person who sat at the table with you was busy surfing the web or texting someone else on their laptop or cell phone rather than interacting with you?

Conversely, have you ever experienced a difficult time in your life when someone came along and offered support in such a way that you felt cared for? This person may have been calming, reassuring, easy to talk to, and—most importantly—they understood your struggles.

The simple gift of another’s presence can be healing.

We all want the Best Care for our patients—we want to be sure they are cared for in the safest, most effective and most compassionate way. In a fast-paced care environment, however, it may sometimes happen that we forget that patients can feel vulnerable and nervous when in the hospital (or even in a clinic setting). In a hospital in particular, there are times when a patient can’t care for themselves. At other times, if left unattended, the patient could become a safety risk to themselves or others. At these times, they need compassionate, one-on-one observation to remain calm, safe and secure. Being closely watched also helps ensure they receive the highest standard of care possible. This is one reason why there are windows that look into the patients’ rooms at every nurses’ station in our hospital units.

Positive regard for another as a human being with value is at the heart of true caring. Engaging with someone usually extends beyond the exchange of words. It means we share our presence, including our behavior and actions. The way we talk to patients and visitors, the way we look at them, the whole quality of our presence, can make them feel understood and help them feel at ease. These compassionate behaviors help foster feelings in the patient and their family that we truly want the best possible outcome for them. In turn, their sense of well-being can promote wellness—did you know that, according to the Centers for Disease Control and Prevention (CDC), higher levels of well-being are associated with better immune functioning and speedier recovery? Our potential to affect others by being present is both a great gift and a great responsibility.

One patient sitter at UTMB, Joe Romfeld, demonstrated just this sort of compassionate care for one of our patients. Of Joe, a colleague recently wrote:

“Joe was an excellent patient care technician/sitter today. He was very attentive to our patient. He made sure the bed had fresh linens and that the patient had a clean gown. He even went so far as to disinfect the entire mattress before he put the clean sheets on. He made sure that the room was neat, and he disinfected all the hard surfaces in the room.

The patient had several episodes of nausea and vomiting, and Joe was very caring and compassionate. He did not get on a cell phone once today, and he sat in the room with the patient and made the patient feel comfortable and at ease.

I tell you this because it was so refreshing! In some of my past experiences with sitters, if they are in the patient’s room, they are often on their phones. Sometimes, sitters sit outside the room and have little interaction with the patient. Every time I went in the room, Joe asked me how he could help.

He is such a hard worker! He should be starting nursing school this coming fall, as he is just finishing his pre-requisites. He would be a wonderful employee—kind, compassionate, caring and a very hard worker. I have known Joe for over a year and have had opportunity to work with him many times. He has always had a strong work ethic and always put the patient first. I feel like a better person because I got to work with him today.”

Our caring presence is a way we can all demonstrate Best Care at UTMB. Whether we deliver care or simply interact with patients and visitors, we can be mindful of how others may be feeling. Even a momentary interaction can make a difference. Let us all consider ways we can cultivate our attention and our ability to attend closely to those around us, and in this way, we can bring care and concern to others. Take some time to give others the gift of your kindness!

“Never worry about numbers. Help one person at a time and always start with the person nearest you.” —Mother Teresa

Compassion is a verb.

Donna Sollenberger, EVP & CEO, UTMB Health SystemOne year during the holidays in Wisconsin, I realized I had forgotten to get a greeting card to give to my father-in-law on Christmas morning, which my family celebrates. So my son, Blake, and I went to the local drugstore to find one.

While we were in the greeting card aisle, I noticed another lady who was also looking for a card. She reached the cashier just before we did. Standing in line behind her, we overheard her conversation with the cashier.

“That’ll be $5.99,” he said.

“Oh, I think it is only $1.99,” she replied.

The cashier double-checked the price. “No, it’s $5.99,” he said.

“But it was on the $1.99 rack. It’s for my daughter,” she replied.

The cashier then said, “No ma’am, I’m sorry. It must have been misplaced on the rack. It doesn’t matter where it was, it’s $5.99.”

Clearly disappointed, the woman exited the line to replace the card on the rack. My heart truly went out to her. After I had completed my transaction, my son and I waited outside of the store. I just had this feeling that I needed to do something to help, because I could tell she couldn’t afford the card. When she came outside, we handed her a twenty dollar bill.

“Please, go buy the card you wanted for your daughter. Get her a small gift.”

I don’t know if I can really describe my emotions at that moment, as the lady’s eyes welled up with tears. I just knew I had to do something to help this person in need.

I remembered this experience because we are in the midst of the holiday season, but I wondered if there was something special we could all do for someone else—and not only during the holidays. Every day is a day for practicing kindness, compassion and generosity. We have opportunities daily to help our patients and visitors—and it doesn’t have to cost a cent.

Recently, Laura Amos, a patient care technician in the Galveston Recovery Room, stopped to help a patient who was walking with her IV pole in a main corridor of Jennie Sealy Hospital. The patient looked as if she was about to pass out. Laura noticed this immediately and asked the patient if she was okay. When the patient replied that she felt weak and dizzy, Laura stayed with the patient while another employee got a wheel chair. Then, Laura assisted the patient into the chair and helped take her to transportation, who escorted her to her room.

We can always offer something of ourselves to someone else at any time, whether it is our talent or a skill, a little moral support, or a word of kindness. After all, “Generosity does not come from wealth. Wealth comes from the flowers of kindness and love,” says physician and author, Dr. Debasish Mridha.

Laura not only demonstrated compassion for this person, but by being observant and proactively interacting with this patient, she also helped prevent a potential injury to the patient if she had fallen. This is a wonderful example of Best Care, and a wonderful example of how, by simply being aware of those around us in our hospitals and clinics, we have a real invitation to brighten someone’s day.

“The best part of life is not just surviving, but thriving with passion and compassion and humor and style and generosity and kindness.” ~ Maya Angelou

Your silence gives consent. (Plato)

Donna Sollenberger, EVP & CEO, UTMB Health SystemMy passion for history began in middle school. In fact, much of my elective reading has always been about important historical events or the lives of famous people. Most of all, I really enjoy reading about the lives of presidents. Given the fact that I grew up in Springfield, Illinois, it probably would not surprise you to find out that I love to read about Abraham Lincoln. As a child, I grew up visiting Lincoln’s home and tomb, the Old State Capitol where the Lincoln/Douglas debates were held, and New Salem where a young Abraham Lincoln studied law by candlelight. Perhaps it also is not surprising that I love to read about President John F. Kennedy. When President Kennedy was shot, I was in middle school. That day was a defining moment in my youth. Even now, I read as much as I can about these two presidents.

Traveling a couple of weeks ago, I had forgotten my book. (I have a Kindle, but I still love to turn pages!) In the airport, I saw a paperback book called “Killing Kennedy: The End of Camelot”, written by Bill O’Reilly. I decided I would buy it, and I read it on the plane. To me, the best part of the book was about John F. Kennedy’s time in the Oval Office. In particular, I was fascinated by the account of the Cuban Missile Crisis and the Bay of Pigs.

In April of 1961, President Kennedy had made the decision to authorize the invasion of Cuba. First, however, he wanted to hear from his top advisors to determine if this was the best course of action. At the time, his Secretary of State was Dean Rusk, an Oxford-educated Rhodes Scholar who had served as a chief of war plans during World War II. He was experienced in organizing covert missions similar to this.

Dean Rusk had not been President Kennedy’s first choice as Secretary of State, and Secretary Rusk knew that. Consequently, he was not confident of his relationship with the new President. In a time when the President truly needed his advice, Secretary Rusk felt he should remain silent, despite the fact that he had shared with others that this operation was misguided and that it had a “snowball’s chance in hell” of succeeding.

Secretary Rusk was not the President’s biggest problem. His largest problem was that not one of his advisors was willing to give him their advice, because it was contrary to what the President wanted at that time. As a result, Kennedy gave the go-ahead on April 14, 1961 to proceed with the invasion. Almost immediately, the invasion was a disaster. Fidel Castro, who had recently overthrown Cuba’s American-backed president, had learned about the attack in advance from informants; meanwhile, the operation of attack did not go as planned. As a result, the Bay of Pigs invasion failed, and after less than a day of fighting, 110 men on the American side were killed and nearly 1,200 were taken prisoner.

This story resonated with me because perhaps the outcome of all of this could have been avoided if the people surrounding the President had been willing to speak up. But when they did not, many people paid the price for that decision.

Sally Hogshead, an author and professional speaker, once stated, “You will not make a difference by being quiet. You will make a difference by being heard.”

As a leader, I want people to challenge my thinking. It may not change my decision, but good decisions are made when all perspectives are heard. This does not mean the leader will always change his or her mind, but it does mean that all voices have been heard and considered.

Best Care requires that we speak up when we see something that can or may result in patient harm, and it requires that the person receiving the message listen carefully to what is being said. At UTMB Health, we are dedicated to serving others and improving the patient and family experience. We achieve this through demonstrating respect for our patients, their loved ones and our colleagues. When we respectfully offer constructive feedback, we do so with the intent to offer information that calls attention to a problem or prevents a potential problem. The objective is to have a conversation that leads to the best solution or course of action. Whether you are the individual receiving the feedback or the person delivering the message, maintaining a spirit of mutual respect and learning is of paramount importance.

As the person speaking up, we need to remember the following:

  • Whenever possible, convey your positive intent by choosing a good time to talk, when the other person can listen and respond thoughtfully. In instances when you are caring for patients, you may have to speak up at that moment in order to avoid patient harm.
  • Let the person know that you respect his or her position/role, and that is why you are willing to share this feedback. It is always best to discuss concerns directly with the other individual—avoid communicating through a third party. Take care with your words—focus on the behavior or action that needs improvement, not on the person. It is helpful to link the behavior or action to patient safety or other important business needs.
  • Maintain an objective tone. Listen objectively, as well.
  • Try to keep your message brief and concise. When possible, consider picking out one or two significant consequences of the action and discussing them.
  • Be sure to include specific descriptions as part of the conversation. Facts generally point toward a solution.
  • Leave the responsibility for action with the other person. If there is still the possibility for patient harm and the appropriate action is not taken, escalate the concern immediately.
  • Always thank the other person for their time, and ask them to reflect on the message, if that is possible.

As the person receiving the message, we need to make sure that we:

  • Focus on the content of the message, not on the person.
  • Realize and be appreciative that someone is making sure every action taken is being done in the best interest of our patients.
  • Listen calmly and attentively. Try not to plan a response while the other person is speaking (we are not really listening when we are busy thinking of how we will respond).
  • Listen with an open mind and acknowledge the other person’s concerns.
  • Ask questions to confirm your understanding.
  • Try not to take offense—instead, welcome suggestions.
  • Maintain an awareness of your feelings, but also try to suspend judgment or reaction until you have had time to consider the suggestions that were offered. Truly consider what is being said.
  • Respond respectfully, and thank the other person for expressing their thoughts or concerns.

The story of Secretary Rusk and President Kennedy is a great reminder of why every member of the team must be willing to speak up and be heard. It is only when we do this that we will achieve Best Care!

“If we remain silent, we are guilty of complicity.” – Albert Einstein

One person can make a difference, and everyone should try.

Donna Sollenberger, EVP & CEO, UTMB Health SystemBefore I share the patient letter I recently received, I wanted to begin with a story. Written by Loren Eiseley, I thought it was a great example of how each of you, through your everyday service and care of our patients and their loved ones, make a big difference. Although you may not always immediately see or hear about how the work you did impacted someone else’s life, your efforts often carry a significance far greater to others than you may realize.

“Once upon a time, there was a wise man who used to go to the ocean to do his writing. He had a habit of walking on the beach before he began his work.

One day, as he was walking along the shore, he looked down the beach and saw a human figure moving like a dancer. He smiled to himself at the thought of someone who would dance to the day, and so, he walked faster to catch up.

As he got closer, he noticed that the figure was that of a young man, and that what he was doing was not dancing at all. The young man was reaching down to the shore, picking up small objects, and throwing them into the ocean.

He came closer still and called out “Good morning! May I ask what it is that you are doing?”

The young man paused, looked up, and replied “Throwing starfish into the ocean.”

“I must ask, then, why are you throwing starfish into the ocean?” asked the somewhat startled wise man.

To this, the young man replied, “The sun is up and the tide is going out. If I don’t throw them in, they’ll die.”

Upon hearing this, the wise man commented, “But, young man, do you not realize that there are miles and miles of beach and there are starfish all along every mile? You can’t possibly make a difference!”

At this, the young man bent down, picked up yet another starfish, and threw it into the ocean. As it met the water, he said, “It made a difference for that one.”

Each day, when you do something special for a single patient, for all of our patients as a whole, or even in support of a colleague, it matters. The letter that follows, which was written by a patient’s wife, provides a powerful example of how one of our employees, Care Manager Mary Jacinto, made this sort of tremendous difference in a family’s life.

As you know, a key strategy of UTMB’s Best Care initiative is to manage our patients’ care, not only while they are in the hospital, but also after they are discharged. For many patients, this is to help prevent readmission (for example, the care manager may follow up to make sure the patient is taking their prescribed medications); for others, the goal is to help patients transition to another level of care or to help them find the resources they need to continue their care plan once they’re home. This letter tells the story of how, through Mary’s actions, she helped save a patient’s life:

“We want you to know how Mary Jacinto helped save my husband’s life. Back in September 2015, Michael [patient’s name is used with permission] got sick and was admitted to UTMB Galveston. Michael had cirrhosis with ascites, an enlarged spleen, an aortic aneurysm, hepatitis C and chronic obstructive pulmonary disease (COPD). After Michael was discharged, this is where Mary came into our lives as Michael’s Care Management Nurse.

We didn’t have insurance and little money. Mary got Michael lined up with the Freeport Clinic, so he could get the medical attention he needed. He wasn’t getting better and needed further medical attention. Mary used her resources and got Michael set up as a casebook study at UTMB.

In May 2016, we found out Michael had liver cancer and without a transplant, he only had a year to live. We still did not have insurance. I had tried several times to get insurance and wasn’t successful. Mary took the time to sit with me, and we did a conference call with the Health Market Place. We got insurance, effective June 1, 2016.

Then, Mary got Michael set up with the Liver Transplant Clinic. On August 8, 2016, Michael got a liver transplant at UTMB Galveston. He is doing fine and is very thankful to be alive. Because of Mary’s persistence, perseverance and caring ways, Michael is alive today! She is a very special person! We call her our angel! We want Mary to get the recognition she deserves.”

This is just one example, but this sort of amazing care takes place every day at UTMB. I can go on and on with examples of how individuals and teams across UTMB contribute to Best Care. In fact, just the other day, after a power outage in League City, individuals from Clinical Equipment Services, Nursing Services and many other areas discovered and preempted a potential patient safety issue with back-up batteries and emergency power. They then immediately took action to resolve the problem in a single evening. Some of the individuals who helped weren’t even on schedule that night, or they came in early the next morning to ensure everything had been addressed. To me, this sort of teamwork is outstanding and it proves that often, it is not one person or one action that makes the difference; it is the collective efforts of many who are working together toward a common goal.

As we continue the Best Care initiative and receive feedback from groups across the organization, leadership has learned that many people still aren’t sure how they impact Best Care. Although Best Care is largely focused on some areas for improvement that are difficult to impact for those who do not deliver direct patient care, I want to emphasize that each of you plays a very important role to the overall Best Care initiative. When it comes to helping patients navigate the health care system, ensuring they have a positive experience, or making sure needed supplies are delivered and facilities are operational, through your collective service, you make an impact.

Never doubt that one person’s efforts can make a difference. It did for Michael and will for so many others.

November 11 is Veteran’s Day.



It is in the shelter of each other that the people live.

Donna Sollenberger, EVP & CEO, UTMB Health SystemThere is a proverb that says, “It is in the shelter of each other that the people live.” Have you have been in a position at some point in your life when you had to rely on the generosity of others? I would guess that most of us have. I know it has been true for me.

When I was 15 years old, my father unexpectedly lost his job. With three children and a wife to support, he was devastated and very worried about our family’s future. Fortunately, two things happened which made it possible for our family to transition through this challenging time until he got a new job.

First, my parents decided that my mother should return to work. In the mid-1960’s, a mother working outside the home was not the social norm. Nevertheless, my mom had been an exceptional legal secretary before she decided to stay home to focus on raising me, and eventually, raising my brother and sister. Fortunately, she had stayed in touch with her former employer during this time. So when my dad lost his job, my mom made an appointment to meet with her former agency to see if they had any job openings. Fortunately, they were hiring, and they offered her a job on the spot.

I remember there were tears of relief when my mother came home to say she would start working the following Monday. Because I was the oldest, my mother sat down with me to ask for help. She would need someone to be home for my brother and sister when they returned from school, and she would need me to cook dinner. I was so relieved that she would be able to help my dad and our family that I quickly agreed to do as she asked, even though it meant I would be giving up some of my after-school activities. To me, it felt like a small price to pay for my family’s future.

The other source of help we received came from my grandparents. I am not sure if my parents ever realized that I had overheard them asking my grandfather for a loan until we could get back on our feet. Fortunately, this is something my grandfather was able to do, and he told my parents not to worry about paying him back until they felt they were in a position to do.

This period of my life taught me a lot. First, the example of my mother’s former employer hiring her back on the spot taught me that it is important to stay in touch with people with whom I have worked in the past, as well as the importance of doing the best job possible while in their employ. Whether this relationship results in receiving a good reference or in assistance getting another job when the time is right, former employers and supervisors can be invaluable in helping us find future opportunities, should we ever need their assistance.

Secondly, and most importantly, I learned about the generosity of others and how it can make a tremendous difference in another person’s life when they need help. Whether the difficulty is losing a job, coming down with a serious illness, or any number of unfortunate and unforeseen circumstances, anyone can experience a situation in which they may someday need to rely on the help of others. This is the lesson foremost on my mind this week as we approach the close of this year’s State Employee Charitable Campaign (SECC), which ends on November 14.

Because of my experience as a 15-year-old, I have always supported organizations I believe in, such as the more than 300 charities represented by SECC. I have found that there are few things in life as satisfying as giving generously to help others, even though we may never know who has benefited from our gift.

For those of you who have already given to SECC, thank you! To those of you who have yet to donate, I hope that you will do so today. No amount is too small, and it is so easy to give. You can write a check for a one-time donation, or you can make a one-time or monthly gift through a payroll deduction. I know that some of you may not be in a position to give, but for those who are, please donate today. And remember, no gift is too small—we are harnessing the power of collective giving. Together, UTMB’s contributions will go far!


Happy National Radiologic Technology Week (Nov. 6 – 12). Thank you for everything you do to deliver excellent patient care and promote healthcare safety!